St. Louis gave teens free birth control, and they now have very low abortion rates

Since 2007, a program in St. Louis has offered teenagers free access to all types of birth control. They can choose pills, intra-uterine devices or any other FDA-approved contraceptive. These St. Louis teens have had markedly lower pregnancy, abortion and birth rates than the rest of the country, new research published in the New England Journal of Medicine shows. This is what their pregnancy rates look like, compared to the rest of the United States. The CHOICE Project, run out of Washington University in St. Louis, advertised the free contraceptives to local teenagers through flyers, doctors’ offices and word-of-month. The program has, so far, provided more than 9,000 teenage women with no-cost contraceptives. Lots of participants in the program choose a long-acting, reversible contraceptive (LARC) that a doctor has to implant. These types of birth control tend to be the most effective because, once inserted by a doctor, they require no work on the part of the user. (Birth control pills that have to be taken every day, meanwhile, leave huge space for user error.) When financial and medical barriers are removed, it turns out teenagers this form of birth control more than they use pills: nearly three-quarters of the CHOICE Project participants in this study used some form of LARC, such as an IUD. Separate research has found that, nationally, just 4.5 percent of teenagers use this method. Separate programs have had similarly dramatic results: Colorado saw teen birth rates decline 40 percent when it began providing free access to IUDs. "We found that in a cohort of teenage girls and women for whom barriers to contraception (lack of knowledge, limited access, and cost) are removed and the use of the most effective contraceptive methods is encouraged, a large percentage opted to use LARC methods," the authors write. And when teens choose the more effective forms of contraceptives, it turns out, they get pregnant less and have fewer abortions and fewer babies.